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DH pilot to judge GPs on whether patients feel better

Exclusive GPs are being judged for the first time on how successful they are at making patients feel better, with the start of a DH pilot of questionnaires asking patients about their health and wellbeing before and after treatment.

The questionnaires will for the first time ask for patients' feedback on the quality of GPs' clinical skills, asking patients to assess their ‘health status' before, and one year after, treatment for one of six long-term conditions.

The pilot, due to end next summer, uses questionnaires sent out to 2,250 patients with asthma, COPD, diabetes, epilepsy, heart failure and stroke to assess the feasibility of using patient-reported outcome measures (PROMs). It will inform the DH's decision on whether PROMs can be used to assess GPs ‘on a large, national scale'.

Professor Ray Fitzpatrick,  professor of public health and primary care at the University of Oxford – who is leading the pilots in 30 practices in London and the north-west of England – said GPs had been ‘enthusiastic'.

He said: ‘I expected a slightly more guarded and cautious response. I have had discussions with professional organisations, where it became clear that they did have some more concerns – but that wasn't reflected [among the] grassroots.'

PROM questionnaires, the brainchild of Lord Darzi's Next Stage Review, are currently used to rate improvements patients feel after four elective procedures – hip and knee procedures, groin hernia surgery and varicose veins operations – with hospital payments tied to patients' ratings. But any attempt to tie GP incentives to PROMs would be hugely controversial.

Dr Beth McCarron-Nash, GPC negotiator and GP in St Columb Major, Cornwall, said: ‘There is very little evidence for PROMs within primary care. Anything that is part of the QOF needs to be evidence-based.'

Dr David Bailey, chair of GPC Wales, said: ‘PROMs are fine if you are talking about how well you have done with your hernia operation. I'm not sure [they offer much] when you are talking about how well you think your hypertension is being managed, because it is very difficult to tell until 15 years later.'


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